On Sun 11 May, David Havard wrote:
> Thank you for the welcome Barbara. As promised in an earlier e-mail,
> here is an introduction. =20
>(snip)
> In January this year I started on Pergolide. I have not been happy with
> this drug as there were significant side effects. The worst
> side-effects were a feeling of drowsiness, loss of concentration and an
> impairment of the ability to focus with my eyes about one and a half
> hours after taking the tablets. The side-effects are still there but to
> a lesser extent. I was advised to reach a dosage of 500 micrograms three
> times a day. I have never consistently reached the advised dosage
> (always knocking off 125 here and there). =20
> =20
> The medication is probably my most significant worry at the moment. I am
> not sure how to use it. I try 8 hour intervals to give three times a
> day, but this is rarely consistent because I modify the time of taking
> the Pergolide so that any drowsiness does not affect meetings etc at
> work. My wife notices that at the end of a medication period I seem much
> better! I do not even know if it is meant to be taken every 8 hours or
> breakfast, lunch and dinner (asked my local doctor and he thought the
> former was ok but see below).
>
> =B7 The last two years have been the toughest in terms of work for my
> whole career. I do not wish to give up work and this is a high
> priority (my immediate General > =B7 So far the impact of the disease has
been limited, and I have largely ignored it . However, I cannot help but
think about it many times a day and this is > wearing. =20
>=20
> David=20
Hello David. You may find the following points useful:-
1) Pergolide appears to produce undesirable side-effects in a small but
significant minority of people. Only you can determine what is for you an
unacceptable side-effect. The good news is that (dependant on where you
live) there are up to 5 different Dopamine Agonists (as the Pergolide-type
drug is called). They all perform similarly as replacements for the direct
tablets of levodopa, but it seems that if a person finds one type giving
side-effects, there is usually another which does not. Unfortunately, I have
no idea what is available to you in Indonesia. I will append a list of all
the Pergolide-type tablets as you may find them useful.
Dopamine Agonists
Parlodel (Bromocriptine)
Lisuride (Revanil) =20
Permax (Pergolide, Celance) =20
ReQuip (Ropinirole) =20
Cabaser (Cabergoline)
Myrapex (Pramipexole)
=20
=20
Regarding the times at which you should take Pergolide, it relly is not
critical. This is because the residence time of these drugs in the brain is
long long, and when you change the dosage, it takes several days/ weeks
tostabilise at the new level. I would be surprised if you can really
differentiate between individual doses.
Another subject which you should be aware of is that of when to make a start
on tablets containing levodopa. This vital subject is one which finds the
experts split into those who would introduce it early on in the treatment,
and those who try everything before finally resorting to levodopa. The
choice which you face is highly relevant to your job,etc, and if you want, I
will lay the whole story out for you. Look forward to hearing from you.
Regards,
=20
-- =20
Brian Collins <[log in to unmask]>
